This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
A Quick Look at Quality
Quality health care means doing the right thing, at the right time, in
the right way, for the right person—and having the best possible
Although we would like to think that every health plan, doctor,
hospital, and other provider gives high-quality care, this is not
always so. Quality varies, for many reasons.
Fortunately, there are scientific ways to measure health care quality.
These tools, called measures, have mostly been used by health
professionals. They use measures to check up on and improve the
quality of care they provide.
But there is some quality information you can use right now to help
you compare your health care choices. And more and more is becoming
available all the time. Many public and private groups are working to
improve and expand health care quality measures. The goal is to make
these measures more reliable, uniform, and helpful to consumers in
making health care choices.
What is Measured?
There are two main types of quality measures that can help you choose
quality health care: consumer ratings and clinical performance measures. Both types are based on "outcomes research."
Outcomes research measures the end results of health care practices
and treatments. For example, after treatment, is the pain gone? Can
the patient carry out his or her daily activities? Is he/she satisfied
with his or her care?
Consumer Ratings (or "consumer satisfaction" information)
at health care from the consumer's point of view. For example, do
doctors in the plan communicate well? Do members get the health
services they need?
Many consumer ratings of health plans are based on a survey called the
Consumer Assessment of Health Plans (CAHPS®) and on the Health Plan
Employer Data and Information Set (HEDIS) member satisfaction survey,
which includes CAHPS® questions.
Clinical Performance Measures (also sometimes called "technical quality" measures)
Some widely used clinical performance measures are included in HEDIS. These measures look at how well a health care organization prevents and treats illness. For example, one HEDIS
clinical performance measure looks at whether children get the
immunizations (shots) they need when they need them.
More information on CAHPS® and HEDIS is provided in the Choosing a Health Plan section.
Top of Page
What Should I Look For?
You may be able to find consumer ratings, clinical
performance measures, or both in quality reports. Quality reports go
by different names, including performance reports and report cards.
Quality reports don't tell you which health care choices are the best.
But they can help you decide which are best for you, based on the
things that are most important to you.
More information about quality reports is provided in the Choosing a Health Plan and Choosing a Hospital sections.
Another way to compare quality is to use
information about accreditation. Accreditation is a "seal of
approval." It is mainly used for health care organizations such as
health plans, hospitals, and nursing homes.
To earn accreditation, organizations must meet national standards,
often including clinical performance measures. Organizations choose
whether to participate in accreditation programs. Therefore, you will
not find accreditation information on every nursing home, for example.
More information on accreditation is provided in the Choosing a Health Plan, Choosing Treatments, Choosing a Hospital, and Choosing Long-term Care sections.
Top of Page